Examining language and social development in bilingual children with ASD and identifying the barriers to bilingualism for these children

Given Canada’s officially bilingual status and its multicultural profile, many children with autism spectrum disorder (ASD) are brought-up in minority-language or bilingual households. Although language is intimately linked to cultural identity, many families of children with ASD face barriers to raising their child bilingually, which can have important repercussions, both for the child and their family. However, there is evidence that bilingualism may not be detrimental to these children’s language development, and that bilingual children with ASD may present better social abilities when compared to their monolingual peers, which has been found in monolingual children with ASD, to predict future language development.

Thus, the current study aims to better understand bilingual language development in children with ASD by examining the trajectories of language and social development in bilingual and monolingual children with ASD from early childhood to middle school, and the relationship between these two variables. To do so, longitudinal data will be analyzed using growth curve and pathway analyses. In addition, using a thematic analysis, we aim to identify barriers to bilingualism across Canada and specifically in the province of Québec, with a focus on barriers within the healthcare system.

Results from this study will serve to better inform clinicians about the language and social development of bilingual children with ASD, and to inform the development of evidence-based recommendations and interventions geared towards these children. Additionally, by identifying barriers to bilingualism, we aim to pinpoint areas where knowledge mobilization is required, thus diminishing, and even eliminating these barriers.

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Outputs:

• Unknown. (May 2022). Examining the Influence of Bilingualism on the Narrative, Social and Pragmatic Abilities of School-Aged Children on the Autism Spectrum [Poster presentation]. International Society for Autism Research, virtual conference.

• Unknown. (April 2022). Bilingualism, narrative, social and pragmatic skills in children on the autism spectrum [Oral presentation]. Speech-Language Pathology and Audiology Canada-Virtual Convention.

• Unknown. (August 2021). Examining the barriers and facilitators to bilingual language development in children with neurodevelopmental disorders [Symposium]. COUHR National Symposium. Virtual conference

• Unknown. (August 2021). Examining the barriers and facilitators to accessing healthcare and to receiving equitable health services: a literature review [Symposium]. COUHR National Symposium. Virtual conference

• Unknown. (April 2021). Does bilingualism influence the narrative, social and pragmatic skills of children on the autism spectrum [oral presentation]. Transforming Autism Care Consortium Pre-INSAR Blitz. Virtual presentation.

Increasing French Language Proficiency at the Ingram School of Nursing: Evaluating the Impact of a French Proficiency Requirement for Admissions

Proficiency in French is increasingly required by Ingram School of Nursing (ISoN) clinical partners. As the proportion of French speaking patients increases, students must be able to speak and write in French to ensure safe, high-quality patient care. Additionally, French proficiency is a requirement of nursing licensure and practice in Quebec. Anecdotal reports suggest that low French proficiency is a significant reason ISoN graduates leave Quebec to practice. To address training and retention issues, the ISoN implemented a French proficiency requirement for admission to entry to practice programs. This marks a significant shift in the ISoN admissions criteria for the Bachelor of Science in Nursing [BSc(N)] and Master of Science in Nursing – Direct Entry [MSc(A)–DE] programs and has potential implications for the ISoN student population, faculty, clinical partners, program graduates, and employers.

The proposed 18-month pilot project will document the implementation of the French language proficiency requirement over the 2020-2021 and 2021-2022 academic years. A utilization-focused evaluation approach will provide a framework for the project. Research methods include quantitative analysis of administrative data and qualitative data collection through in-depth interviews with key stakeholders. The primary goals of the project are to: 1) sensitize stakeholders to the change in admissions policy; 2) evaluate the initial impact of the change on key stakeholders; 3) develop and refine data collection tools and strategies for long term evaluation and research, and; 4) identify possible strategies for optimizing retention of bilingual (French and English) nurses in Quebec.

Safe Patient Handling and Mobility Training for English-Speaking Nursing Students using Augmented Reality: Prototype and Testing

Patient handling tasks are the biggest risk factor in the development of musculoskeletal injuries among nurses. Nursing students are equally vulnerable and today their education of ‘safe patient handling and mobility’ (SPHM) is shared between the academic and clinical settings. Students often deviate from what was taught in class, upon arrival in the workplace, which may be due to the use of passive learning instructions. While the use of augmented reality (AR) in nursing is in its early stages, benefits include the ability to gain hands-on experience in learning a skill, increased confidence, and instantaneous feedback. This project aims to develop and test 2 AR clinical scenarios to provide SPHM training to 1st year English-minority speaking nursing students enrolled at the Cégep Saint-Hyacinthe. The objectives are to: 1) create the clinical scenarios and algorithms to train students in SPHM, 2) develop the AR-environments, and 3) explore students’ and educators’ experiences using AR for SPHM training. After obtaining ethics approval, a qualitative descriptive design will be used to explore the experiences of a purposive sample of 14 students and 8 nurse educators. Data will be collected in Winter 2022, and transcripts will be content analyzed. Proper SPHM training of nursing students is critical as evidence suggests that they are developing lower back pain during their 1st year of training. There is potential in using AR for SPHM skill training of students, nurses, and other healthcare workers, and this approach should be integrated in healthcare organization to reduce injuries.

Utilizing Multilingual Medical Students and the MedComm Platform to Address Language Barriers in Healthcare

The use of professional medical interpreters is considered the highest standard in medical interpretation. However, there is currently no universal, sustainable, and feasible medical interpretation service offered across McGill-affiliated healthcare sites. Our proposal includes three projects, each addressing the need for accessible interpretation services for patients with language barriers.

First, we would like to deliver a workshop on the basics of medical interpretation to all multilingual medical trainees at the McGill School of Medicine and study the impact of this workshop on students’ knowledge and self-perceived qualification to serve as an interpreter. Second, we would like to develop and implement a series of educational workshops for a wider range of healthcare trainees at the McGill Faculty of Medicine. These workshops will cover the basics of interacting with an interpreter in a medical appointment and will teach the participants how to access interpretation services. Lastly, we want to develop an online and mobile platform for requesting the services of trained student interpreters and conduct a pilot study to test the utility and feasibility of the platform in the clinical setting. Through our work, we also aim to build cultural competency among healthcare trainees by raising awareness of the issue of language barriers, their effects on linguistic minorities, and the importance of availability of professional interpreters.

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Outputs:

1. Unknown. (2021, April). Interpretation Training for Multilingual Medical and Dental Students: A Pilot Study of a Virtual Interactive Workshop [Presentation]. Canadian Conference on Medical Education.

2. Unknown. (May, 2021). Virtual Interpretation Workshop for Multilingual Medical and Dental Students: A Pilot Study [Presentation], MASH/MJM Interprofessional Health Research Symposium.

3. Unknown. (December, 2021). MedComm Platform: A Tool for Managing Requests for Medical Interpreter [Poster presentation, virtual]. Annual 2021 Dialogue McGill Conference, virtual.

4. Unknown. (December, 2021). Working with Interpreters: Virtual Workshop for Medical and Dentistry Students [Poster presentation, virtual]. Annual 2021 Dialogue McGill Conference, virtual.

5. Unknown. (2022, April). Working with Interpreters: Virtual Workshop for Medical and Dentistry Students [Poster presentation]. Ontario Student Medical Education Research Conference.

Improving language awareness in mental health care by engaging clinicians of language diverse patients

Despite the diverse linguistic profiles of patients at inner city hospitals, language barrier between patients and clinical staff remains neglected. Reasons may include lack of awareness of language barrier by clinicians and silencing of barriers by organizational practices and management priorities. From prior research, inpatient psychiatry nurses and medical students are least likely to seek the help of interpreters when faced with patients that don’t speak English or French. Reasons for these practice patterns are unknown.

Developing previous work, this study aims to clarify the quality of language barriers in clinical settings, focusing especially, but not uniquely, on the work of nurses and medical students, to (1) document clinician awareness of language barriers in their patients; (2) explore how awareness of language barriers can be enhanced professionally and institutionally; (3) evaluate the discourses reinforcing language barrier in clinical practice; and (4) assess whether promoting awareness of language barrier results in a measurable increase in documentation of language dynamics in patient charts and a corresponding increase in clinician satisfaction working with language diverse patients in clinical mental health settings. Investigators hypothesize that after focus groups on language barrier over one year on psychiatric services, measurements at Time 1 compared to Time 2 will show (1) a statistically significant increase of clinician awareness of language barriers as measured by mentions of language issues in patient charts and (2) greater clinical satisfaction working with language diverse patients.

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Outcomes were curtailed by the COVID-19 pandemic.

Clinical Measurement of Verbal Language Proficiency in Patients Referred to a Cultural Consultation Service (CCS).

The Cultural Consultation Service of the Jewish General Hospital has been evaluating the mental health of immigrants and refugees since 1999. As may be expected, CCS patients from linguistically diverse backgrounds need interpreter services, but how clinical decisions are made to assign interpreters to a given patient are unknown. Furthermore, there are no clinical language proficiency tools available for use in health care settings. Health care literacy tools exist, but before they can be administered to patients of diverse backgrounds, basic verbal language proficiency in English must first be evaluated. Using a retrospective sample of CCS referrals, this study will demonstrate that clinicians overestimate language proficiency in linguistically diverse patients. Then, a simple tool to measure verbal language proficiency, which can be administered quickly and efficiently in clinical settings, will be piloted on a prospective sample of CCS referrals to address this problem.

Do Language Barriers Impact COVID-19 Vaccine Hesitancy among Quebec Visible Minority Groups?

Language barriers are an important obstacle when it comes to vaccination and may even result in a lack of access to COVID-19 information. The prospect of new waves of COVID-19 infections poses a special risk to English-speaking visible minority communities across Quebec due to the increased levels of infection and death. Visible minorities bore the brunt of the first waves of the pandemic, and evidence suggests that they have high levels of vaccine hesitancy. Vaccine hesitancy is characterized by a lack of confidence in vaccination and/or complacency about vaccination. Black and other visible minority communities have shown greater hesitancy towards vaccinations compared to their white counterparts and receive significantly fewer vaccine doses. We will conduct a 3-wave, prospective, longitudinal study (over a 10-month period) that examines linguistic and motivational factors that impact the readiness of visible minority young adults to get COVID19 vaccines. The study represents an ongoing collaboration of the McGill Human Motivation Laboratory and the Black Community Resource Center (BCRC). The BCRC serves as the secretariat for 14 community agencies that provide services to English-speaking visible minority groups. A novel component of this research is that it will examine how young adults process and respond to public health information intended to promote vaccinations(e.g., emphasis on visibility, relatability, and equity). Both language minority status and visible minority status are expected to be associated with response to these communications. We will develop empirically based resources for Black and visible minority young adults to promote autonomous motivation and positive attitudes about vaccination.

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Outputs:

• Lafreniere, B., Audet, É. C., Kachanoff, F., Christophe, N. K., Holding, A. C., Janusauskas, L., & Koestner, R. (2023). Gender differences in perceived racism threat and activism during the Black Lives Matter social justice movement for Black young adults. Journal of Community Psychology. 10.1002/jcop.23043

• Nweze, N., Davids, J., Fang, X., Holding, A., & Koestner, R. (2023). The Impact of Language on the Mental Health of Black Quebecers. Journal of Racial and Ethnic Health Disparities, 1-11. 10.1007/s40615-022-01412-5

• Audet, É. C., Leboeuf, J., Holding, A. C., Davids, J., Fang, X., & Koestner, R. (2022). Better Together: Family and Peer Support for Black Young Adults During the COVID-19 Pandemic and the Black Lives Matter Movement. Trends in Psychology, 1-18. https://doi.org/10.1007/s43076-022-00157-8

• Audet, É. C., Thai, H., Holding, A. C., Davids, J., Fang, X., & Koestner, R. (2023). The depth of stories: How Black young adults' disclosure of high arousal negative affect in narratives about the COVID‐19 pandemic and the BLM protests improved adjustment over the year 2020. Journal of Community Psychology, 51(4), 1504-1517. 10.1002/jcop.22929

Are language and motivational barriers limiting healthcare access for Black young adults during the Covid-19 Pandemic?

Health care access during the second wave of the Covid-19 pandemic in Canada may be especially problematic for Black young adults who are a linguistic minority in their province. Studies have found marked disparities in access to health care among official language minorities in Quebec (Falconer & Quesnel-Valee, 2014). Intersectionality theory suggests that the combination of marginalized identities could make it uniquely difficult for Black anglophone Quebecers (and Black francophone Ontarians) to feel empowered to seek access health care. A 3-wave prospective longitudinal study will examine linguistic and motivational factors that may undermine the readiness of Black young adults to seek access to health care during the coming fall and winter. The study will assess the extent to which participants have experienced autonomy-support in their interactions with health-care providers and how this relates to their motivation to adhere to public health guidelines regarding the pandemic (e.g., hand-hygiene, social-distancing, wearing masks) and influence the pursuit of health care information and health care access. Researchers will also examine whether the motivational factors interact with linguistic minority status in determining how young adults adapt to the challenge of living through the worst pandemic in a century.

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Outputs:

1. Audet, É. C., Thai, H., Holding, A. C., Davids, J., Fang, X., & Koestner, R. (2023). The depth of stories: How Black young adults' disclosure of high arousal negative affect in narratives about the COVID-19 pandemic and the BLM protests improved adjustment over the year 2020. Journal of Community Psychology, 51(4), 1504–1517. https://doi.org/10.1002/jcop.22929

2. Audet, É.C., Leboeuf, J., Holding, A.C. et al. (2022). Better together: Family and peer support for black young adults during the COVID-19 pandemic and the Black Lives Matter movement. Trends in Psychology. 30, 688–705. https://doi.org/10.1007/s43076-022-00157-8

A Pilot Test of the Edinburgh Postnatal Depression Scale for Cree (EPDS-Cree)

It all begins with an idea. Maybe you want to launch a business. Maybe you want to turn a hobby into something more. Or maybe you have a creative project to share with the world. Whatever it is, the way you tell your story online can make all the difference.

Don’t worry about sounding professional. Sound like you. There are over 1.5 billion websites out there, but your story is what’s going to separate this one from the rest. If you read the words back and don’t hear your own voice in your head, that’s a good sign you still have more work to do.

Be clear, be confident and don’t overthink it. The beauty of your story is that it’s going to continue to evolve and your site can evolve with it. Your goal should be to make it feel right for right now. Later will take care of itself. It always does.

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Outputs:

• Unknown. (December 12, 2019). Cross-Cultural Adaptation and Validation of the Edinburgh Postnatal Depression Scale for Cree (EPDS-Cree). Presentation to Mental Health Advisory Panel, Cree Board of Health & Social Services of James Bay. Montreal,

Impact and Outcomes of Deaf Cultural Competency Training Workshops for Medical Students and Residents

The objective of the current project is to increase knowledge and understanding about serving Deaf patients in the context of heath care provision. Medical students and residents will become familiar with appropriate communication strategies, and be provided with detailed information about how to access specialized communication resources to facilitate interactions with Deaf patients.

Prior to our interactive lecture, a focus group will be held with members of the Deaf community. Our objective is to ensure that the diverse needs of the Deaf community – including considerations of gender, age and ethnicity – are adequately incorporated into our interactive lecture design.

Following from our 2017 pilot Project (where we held the DCC workshop with 2nd year medical students), we now plan to offer our DCC interactive lecture to all interested medical students at McGill University, in all years of training, as well as residents in Family Medicine.

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Outcomes:

1. Unknown (2019, April). Pilot project: Implementation of Deaf Cultural Competency Training in the McGill Faculty of Medicine’s Undergraduate Medical Curriculum [Poster presentation]. Canadian Conference on Medical Education, Niagra Falls, Ontario, Canada